What is Obesity?
Obesity is a chronic disease caused by a combination of genetic, biological, and environmental factors. The disease, diagnosed as a body mass index (BMI) of 30 or greater, raises risk factors for many medical conditions including heart disease, type 2 diabetes, high blood pressure, joint pain and breathing difficulty just to name a few. Excess weight has a significant impact on our physical, mental, and financial health. That is why it is important to have conversations with your health care providers about your concerns with overweight and obesity, just as you would for other conditions.
Diagnosing and treating obesity requires a comprehensive approach to your needs along a full continuum of care. Elements of the obesity care continuum might include: meeting with an obesity care specialist to set, discuss and monitor your BMI goals; learning new personal training and nutritional approaches; scheduling sessions with a mental health professional to break down eating disorders; seeking prescriptions for anti-obesity medications (AOMs) where applicable; and being open to surgical intervention where necessary. These supports can be selected for the appropriate combination that’s right for you, and adjusted as you reach and maintain your goals.
Latinos & Obesity:
According to the CDC, approximately 44.8% of Latino adults live with obesity, the second highest when compared to other ethnic or racial minority groups. Among Hispanic American women, 78.8% are overweight or obesity. As one of the fastest-growing segments of the population, there are several factors that contribute to obesity rates being higher in the Latino community including lack of access to affordable healthy foods, safe places to exercise/play, stable and affordable housing and access to quality health care and social or cultural attitudes about body weight all play a role in the likelihood that a person will have obesity.
Many Latino families live in food deserts and do not have easy access to affordable or good-quality foods. Because of this disparity, these families resort to cheaper and less nutritious alternatives. Nearly one-third of Latinos eat two or fewer servings of fruit and vegetables a day and 40% say that fruits and vegetables are too expensive. Furthermore, Latinos have the highest uninsured rate of any racial or ethnic group in the US. In 2017, 17.8% of Latinos were not covered by health insurance compared to 5.9% of non-Hispanic whites. Studies have demonstrated that uninsured people are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.
Culturally Competent Care
It is important to have diverse doctors in healthcare to help the system to adhere to unique social, cultural and linguistic needs of their patients. Minority groups, including Latinos are underrepresented in healthcare. This lack of representation can lead to poor quality of health for minority groups because of the implicit ethnic/racial biases people hold; additionally, there is a lack of understanding for our specific needs.
Read Dr. Jose Aleman’s testimony regarding the important research he is conducting surrounding fat tissue and how it affects the body and can predispose a person with obesity to other diseases that disproportionately affect minority groups.
Blog: Curbing the Obesity Epidemic in the Latino Community Dr. Jose Aleman Diaz, Endocrinologist NYU Langone Health, Memorial Sloan Kettering
My family has been fortunate that none of us have developed serious complications from our weight. Still, overweight and obesity remain a concern for me when I think about my loved ones and the broader Latino community. Throughout my career I’ve focused on metabolism, the way our body uses and redistributes energy, endocrinology, the science of the body’s glandular systems. Both are integral to how we think about obesity as a disease.
In the Latino community, rates of obesity are higher than in the general population, and they are increasing at alarming rates. It is a multifactorial disease influenced by a person’s environment, lifestyle, access to health care, and more. Most often a person with obesity may need a combination of help from trained physicians, lifestyle interventions, new safe and effective medicines or surgery, in a continuum of care, to reach their health goals.
COVID and Obesity
COVID-19 has disproportionately affected Latinos and other communities of color because of the large percentage that work frontline in the service industry. During the peak of the pandemic outbreak, there were almost two times as many cases in the Latino population than among whites, and Latinos have a hospitalization rate four times higher. Deaths are almost three times higher among Latinos who contracted COVID-19 than white Americans.
Obesity is a strong predictor for complications and increased severity from COVID-19. Compared with patients who are not overweight or living with obesity those who were overweight had 1.84-fold odds of developing severe COVID-19, while those with obesity were at 3.40-fold odds of developing severe disease. A meta-analysis of peer-reviewed papers covering 399,000 patients found that people with obesity who contracted COVID-19 were 113% more likely than healthy people to be admitted to the hospital, 74% more likely to end up in the ICU, and 48% more likely to die. Physiological changes associated with obesity, including impaired immunity, chronic inflammation, reduced lung function, and blood that is more prone to clotting, worsen COVID-19.
Access to Care
There are disparities in health care access and quality of care for Latinos. In the battle against chronic diseases, like obesity, it is important to have an intersectional approach and address the systemic discrimination in healthcare due to race, class, income, education, immigration status, etc. Therefore, Latinos must have access to a full continuum of obesity care including health insurance that supports access to obesity specialists, coverage for anti-obesity medications (AOMs), options to consider bariatric surgery, all of which align with lifestyle changes to a healthy diet and increased activity levels.
- Hispanics have the highest uninsured rate of any racial or ethnic group in the US. In 2017, 17.8% of Hispanic Americans were not covered by health insurance compared to 5.9% of non-Hispanic whites.
- The percentage of Hispanics covered by Medicare has steadily grown since 2008. Seven percent of Hispanics had health insurance through Medicare in 2008 compared to 9% in 2019.
- Latinos are more likely to work in blue collar jobs that are less likely to offer employer-sponsored health insurance, and in the cases when insurance coverage is offered, many are unable to afford the premiums.
Outreach: Lead outreach programs in communities with limited access to resources to promote a healthy lifestyle. Through our awareness campaigns and educational webinars, we are ready to equip the Latino community with plans that become actions to change their lifestyles for the better.
Advocate: We support efforts to address the health challenges associated with obesity and to offer patients the resources and the support they need to maintain a healthy weight. We are working to help recognize obesity as a “disease” to raise awareness and to increase treatment opportunities and options. We support the policy changes and legislation to open insurance coverage to a full continuum of obesity care for patients, including passage of the Treat and Reduce Obesity Act (TROA) and related patient advocacy work.
- The Obesity Action Coalition (OAC) has resources for obesity awareness, education, and advocacy.
- Stop Obesity Alliance – Mental Health and Obesity
- National Minority Quality Forum (NMQF) 2021 Leadership Summit Session: Obesity in Communities of Color
Deeper Dive into Obesity:
There are several factors that lead to obesity. This includes poor diet, absence of an active lifestyle, prevalence of obesity in family history, certain medications, psychological factors, etc. Understanding the causes of obesity helps develop a manageable health plan for individuals and receive the appropriate resources to combat obesity.
- Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, divide your weight in pounds by your height in inches squared and multiply by 703. Or divide your weight in kilograms by your height in meters squared.
Consult Your Physician
Increasingly doctors are being trained to recognize obesity as a chronic disease, diagnose it and treat it. Your doctor may review your weight history, weight-loss efforts, physical activity and exercise habits, eating patterns and appetite control, what other conditions you've had, medications, stress levels, and other issues about your health. Your doctor may also review your family's health history to see if you may be predisposed to certain conditions.
Access to Continuum Obesity Care
- Seeing an obesity specialist The most prevalent chronic disease in our society is obesity. But, many health care professionals aren’t trained in how to diagnose and treat it. Locating an American Board of Obesity Medicine certified physician can help you treat obesity and obesity-related diseases and conditions. They can offer you treatment options like support from a nutritionist, exercise professionals and health coaches, and consultation with a bariatrician. Obesity is a complex chronic disease so there may be certain treatments that work best for you. An Obesity certified clinician will work closely with you to find the combination of treatments that are best for you.
- Insurance covering weight-loss medicine Anti-obesity medications (AOMs) are safer and more effective than ever before. However Medicare and many private insurance providers do not cover these medications, leaving these new therapies out of reach for people in need. This inaccessibility to AOMs is a barriers to healthcare for those in need. It is important to ask your insurance provider whether your treatment is covered by your insurance. It’s also important to advocate for the Treat and Reduce Obesity Act (TROA), a policy that will increase access to obesity treatments, confront the inequities in obesity care, and fight against stigma and weight bias.
- Making healthier choices In addition to your medication, treatments, and physical activity it is important to maintain a healthy and balanced diet. You can start by incorporating more plant-based foods including fruits and vegetables. There are lean sources of protein such as beans, lentils, soy and lean meats. Moderate the amount of fats consumed, and make sure they come from heart-healthy sources, such as avocados, nuts, fish or extra virgin olive oil.
- Exercise People with obesity should get at least 150 minutes a week (roughly 20 minutes per day) of moderate-intensity physical activity to prevent further weight gain or to maintain weight loss. To achieve more-significant weight loss, you may need to exercise 300 minutes or more a week (40 minutes per day).
- Weight loss surgery Weight loss surgery or bariatric surgery can be an option for some patients with obesity. There are different types of bariatric surgeries including gastric bypass surgery and gastric sleeve surgery. According to John Hopkins Medicine, there are other options besides bariatric surgery including endoscopic procedures that are less invasive. It is important to talk to a specialist to determine the best procedure for you. Also, it is worth noting that these weight-loss surgeries are not the solution to obesity, however it can help assist people with obesity. Patients will still have to maintain a healthy diet and physical activity.
For more information about how to calculate your body mass index (BMI) and find an obesity care provider near you please visit www.truthaboutweight.global
LULAC’s Health Mission:
One of the most pressing issues affecting Latinos is health. Disparities in access, quality of service, and the burden of preventable chronic illnesses are rampant. Through our health programming initiatives, LULAC raises awareness in the Latino community about the steps individuals must take to prevent these illnesses by connecting Latinos with national, state, and local resources. LULAC’s work addresses individual and community change, including developing and sustaining partnerships with local communities, schools, health care providers, and government agencies.